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I still feel like calling something like uuid.v4() is easier and less cognitively complex.

There are advantages in monotonically increasing UUIDs, they work better with BTrees and relational databases.

I just meant having UUIDv7 internally, and UUIDv4 externally if date leakage is a concern (both on the same object).

UUIDv7 still works great in distributed systems and has algorithmic advantages as you have mentioned.